Lothians and Edinburgh Abstinence Programme (LEAP)
The Lothians and Edinburgh Abstinence Programme offers a three month rehabilitation programme aimed at abstinence. It is based on the Therapeutic Community model for patients dependent on alcohol and other substances.
To refer to LEAP please use the MENTAL HEALTH drop-down menu on SCI Gateway (Mental Health Edinburgh LEAP (Abstinence programme)).
To refer to the community alcohol services please use the AHP- ALCOHOL PROBLEM SERVICE drop-down menu, which then gives the locality options.
To refer to the Drug Hubs, please use the MENTAL HEALTH drop-down menu which then gives the local Drug Problem Service options.
Please see the NHS Lothian internet for full details of the LEAP programme.
The two Lothian pathways are:
Treatment includes detoxification from alcohol, opiates and benzodiazepines; medical care; group and personal therapy and active linkage to mutual aid and other community recovery resources. Support is offered with housing and social problems and the service includes a training, education and employability programme in partnership with Encompass. Families are supported to recover through the LEAP Family Programme and we offer up to two years of aftercare to patients following treatment – please see the Family Programme leaflet.
Most patients will be offered supported accommodation in the City Centre for the duration of the programme. A few may be able to attend as day patients, depending on assessment.
The programme is open to all patients registered with a GP in Edinburgh, Mid, East and West Lothian. Generally, patients will have been expected to have engaged with local community treatment services before a referral to residential rehabilitation is considered. All patients referred will be invited to an information session (which is also open to patients who are want to find out more about rehab or who do not yet fulfil the criteria for assessment). Assessment will normally only commence if this session is attended.
Although most detoxes take place under LEAP supervision, patients at higher risk (particularly alcohol dependent patients) may need an inpatient detox at the Ritson Clinic at the Royal Edinburgh Hospital. LEAP will arrange this if needed.
Assessments generally take place at LEAP, Woodlands House, Astley Ainslie Hospital, 74 Canaan Lane, Edinburgh EH9 2TB. Edinburgh patients are assessed by social workers from the Rehab and Recovery Team. Patients from East, Mid and West Lothian are assessed by the LEAP team. Edinburgh patients will be expected to attend a weekly ‘Prep for Rehab’ group.
Housing assessments for the residential component of treatment take place at Randolph Crescent Hostel, 2 Randolph Crescent, EH3 7TH by City of Edinburgh Council staff. Dual housing benefit will normally pay for the treatment stay for all Lothian residents on benefits. Those not entitled to benefits may have to pay towards the accommodation costs.
Patients have access to psychiatry and psychology services whilst in treatment, Take Home Naloxone training; BBV screening and immunisation against Hepatitis B.
Our follow up study suggests that patients who complete treatment have high sustained recovery rates.
Enquiries: 0131 446 4400
C.M & I.S 14-03-24
Who to refer:
- Age 18 and over
- Individuals who fulfil the criteria for substance dependence (this need not necessarily include physiological dependence) including alcohol, opiates, stimulants and benzodiazepines.
- If on a substitute prescription are stable (no illicit use – confirmed by toxicology)
- If on a methadone substitute prescription, are on no more than 60mls of methadone at time of referral (and will need to reduce to 50mls by time of admission).
- If on a buprenorphine substitute prescription, are on no more than 20mgs daily.
- If on Buvidal injections, are on 96mgs monthly injection (or weekly equivalent)
- If on diazepam prescription, are on no more than 20mg
- Have not been successful in community treatment
- Seeking abstinence from all mind-altering substances
- Showing signs of motivation for recovery (e.g. engaging in community recovery resources)
- Family members of patients with dependence. This is possible even if the patient does not want to go ahead with a referral – we can still care for their family.
Who not to refer:
- Aged under 18
- who simply want to detox
- using heroin dependently (refer to community services)
- using illicit diazepam
- using regularly on top of their script
- who have not had prior treatment in the community
- whose mental or physical health would prevent them engaging in a rigorous programme
- cognitive impairment would preclude benefit
How to refer:
GP practice-based clinicians can refer through SCI Gateway:
Mental Health–>Edinburgh LEAP (Abstinence Programme).
For those without access to SCI Gateway, referrals can be sent to:
LEAP
Woodlands House, Astley Ainslie Hospital
74 Canaan Lane, Edinburgh EH9 2TB
or by NHS Lothian internal email Leap.programme@nhslothian.scot.nhs.uk.
Patients who have a goal of abstinence are more likely to succeed if they connect with recovering peers through mutual aid and other community recovery resources. (see Resource tab)
Patients should not reduce on opiate replacement therapy without a robust plan in place to prevent harm, including risk of death. Patients should be made aware of risk and how to mitigate it. Generally patients undergoing detoxes or reductions should have input from community support and treatment teams and should have had overdose prevention and take-home naloxone (THN) training.
Early re-titration should be considered if signs of instability develop.
Alcohol patients should not be offered repeated community detoxes because of the risk of cognitive impairment. All alcohol patients should be prescribed thiamine.
Patients interested in finding out more about residential rehab can be referred for an informal ‘Information Session’ to LEAP by email (leap.programme@nhslothian.scot.nhs.uk) or SCI Gateway or letter.
LEAP Family Programme Leaflet (Link to LEAP Internet page)
